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At least 847 records · Page 47Linked to original sources
PubMed1974

Simplified method for diagnosis of genital and ocular infections with Chlamydia.

The diagnosis of infections with chlamydia related to the trachoma agent is best confirmed by isolation of the organism in tissue-culture. A simplified technique using conventional monolayers of McCoy cells can be used as an alternative to current methods involving heavily irradiated cells and appears to be of reasonable sensitivity. Chlamydial infection was confirmed in 38/190 females attending venereal clinics, in 22/35 patients with hypertrophic cervical erosions, and in 7/18 infants with ophthalmia neonatorum.

Adult↗
PubMed1982

Genital and neonatal chlamydial infection in a trachoma endemic area.

85 consecutive male patients with urethritis attending the Medical Research Council outpatient department in Fajara, The Gambia, were investigated for Chlamydia trachomatis infection by intraurethral swab and culture on cycloheximide-treated McCoy cells. 7 specimens were contaminated, but C. trachomatis was isolated from 12 of the remaining 78 (15.4%)--from 8 of 59 patients with gonorrhoea (13.6%) and 4 of 19 with non-gonococcal urethritis (21%). C. trachomatis was also isolated from cervical swabs from 6 of 33 female contacts of men with urethritis (18.2%), 3 of 22 women with gynaecological symptoms (13.6%), and 6 of 87 randomly selected antenatal women (6.9%). Eye swabs were taken from 37 infants with ophthalmia neonatorum; C. trachomatis was isolated from 13 (35.1%).

Adult↗
PubMed2000

T cell immune responses against melanoma and melanocytes in cancer and autoimmunity.

T cell responses specific for melanoma cells and melanocytes appear to be involved in the rejection of melanoma tumors, as well as in the development of autoimmune reactions in patients with Vogt-Koyanagi-Harada disease (VKH), sympathetic ophthalmia, or autoimmune vitiligo. Some of the target antigens for those T cells have been isolated using cDNA expression cloning with melanoma reactive T cells derived from lymphocytes tumor infiltrating (TIL) of patients with melanoma. These include melanocyte specific proteins, such as tyrosinase, TRP1, TRP2, gp100, and MART-1, cancer-testis antigens, and mutated peptides derived from genetic alterations in melanoma cells. Some of the melanoma reactive T cells appear to respond to cryptic or subdominant self epitopes in melanosomal proteins. Modification of those epitopes to increase their immunogenicity by replacement of amino acids at primary anchor residues for peptide/MHC binding, allowed an improvement in immunotherapy for patients with melanoma. Targets for autoreactive T cells against melanocytes in those autoimmune disorders remain to be identified. Isolation of novel target antigens is important for understanding these pathological T cell responses, as well as for developing new diagnostic and treatment methods for these diseases. A variety of techniques, including cDNA expression cloning with T cells, serological analysis of recombinant cDNA expression libraries (SEREX), cDNA subtraction with representational differential analysis (RDA), and serial analysis of gene expression (SAGE) are now being applied to identify novel melanoma/melanocyte antigens recognized by T cells and antibodies.

Autoimmunity↗
PubMed2005

Gonococcal infections in neonates and young children.

Gonorrhea has been recognized since antiquity, and more than 60 million new cases occur yearly worldwide. Much has been learned about the molecular pathogenesis of infection by Neisseria gonorrhoeae, but immunity from natural infection does not protect against reinfection with the same strain, and the goal of a protective vaccine remains elusive. Gonococcal ophthalmia neonatorum is the most common manifestation in infants born to mothers with gonococcal genital tract infections. Genital and pharyngeal gonococcal infections in young children almost always are acquired from sexual abuse by an infected adult. Invasive disease can occur at any age but is uncommon. Nonculture diagnostic tests are widely used in adults, but culture is required in children for medicolegal purposes. N. gonorrhoeae strains have developed resistance to many antibiotic classes, and resistance profiles vary among geographic regions and within regions over time. Current guidelines for treatment of gonococcal infections in children in the United States are reviewed.

Adolescent↗
PubMed1989

[Bromocriptine: a new therapy concept in the treatment of chronic recurrent uveitis?].

Chronic recurrent uveitis still responds unsatisfactorily to therapy. Prolactin, a pituitary hormone that attains high blood levels physiologically in stress situations, has an immune modulating effect. The prolactin antagonist bromocriptine (2 x 2.5 mg/day) was administered prophylactically to prevent recurrence in seven patients with chronic iritis/iridocyclitis or panuveitis (Group A). On this therapy two patients suffered a mild recurrence (in one case in the first month). Another patient developed rebound uveitis after discontinuing bromocriptine medication. Tolerance appears to vary considerably, and in three patients the therapy had to be discontinued because of arterial hypotension and congestive rhinopathy, respectively. The three patients in Group B (with iritis, sympathetic ophthalmia, and intermediate uveitis) received bromocriptine in addition to cyclosporin A after plasmapheresis. This combination resulted in an elevated cyclosporin A plasma level, and the dosage was reduced by 30-50% (plasma level 70-120 ng/ml). With this lower dosage of cyclosporin A, the creatinine level of one of the patients returned to normal. Viewed on the basis of these initial results bromocriptine would appear to reduce the number of recurrences of chronic uveitis. Moreover, the synergism with cyclosporin A, described both theoretically and in an animal model in the literature, appears attainable in therapy.

Adult↗
PubMed1988

[The nervous system and uveitis].

This paper presents a short review of some inflammatory diseases which involve both the nervous system and the uvea, and of some forms of uveitis whose onset could be neurogenic. Multiple sclerosis and reticulum cell sarcoma are examples of systemic neurologic diseases which can be accompanied by uveitis or pseudo-uveitis. Syndromes such as Behçet's or Vogt-Koyanagi-Harada are characterized not only by a highly severe panuveitis but also by the participation of optic nerve, meningeal, and brain tissues in the inflammatory process. The occurrence of sympathetic ophthalmia and herpetic uveitis could to a certain extent be due to a neurogenic transmission of the antigen. For Fuchs' heterochromic cyclitis, however, the old theory of sympathetic nerve dysfunction at its origin is no longer widely accepted.

Animals↗
PubMed1980

Penicillin prophylaxis and neonatal streptococcal disease.

Despite a number of efforts no means of preventing neonatal group B beta-hemolytic strep (GBS) infection by maternal treatment or immunization has proved effective. But impetus to a direct approach to the infant has been provided by the serendipitous discovery that routine penicillin prophylaxis for gonococcal ophthalmia may also protect against GBS. Large-scale controlled studies are now under way.

Female↗
PubMed1987

Postpartum upper genital tract infections in Nairobi, Kenya: epidemiology, etiology, and risk factors.

We investigated the frequency of clinically defined upper genital tract infection (UGTI) and its relation to sexually transmitted diseases and other risk factors among 1,013 women initially studied while in labor at a Nairobi, Kenya maternity hospital. Women were enrolled during labor and followed up at seven days and one month postpartum. Cultures for Neisseria gonorrhoeae and Chlamydia trachomatis were done at enrollment and at day 7. The prevalence of gonococcal and chlamydial infections was 6.7% and 20.8%, respectively. The overall prevalence of UGTI was 20.3%. The development of UGTI was significantly correlated with gonococcal infection (odds ratio, 4.4; P less than .0001), chlamydial infection (odds ratio, 1.7; P less than .02), presence of ophthalmia neonatorum (odds ratio, 2.6; P less than .0001), labor greater than 12 hr (odds ratio, 1.8; P less than .01), and area of residence (odds ratio, 1.5; P less than .05). Postpartum UGTI, an enormous public health problem in Nairobi, would be partially susceptible to antenatal intervention programs focusing on sexually transmitted diseases.

Chlamydia Infections↗
PubMed1988

Infection and disease after perinatal exposure to Chlamydia trachomatis in Nairobi, Kenya.

A cohort of 49 infants exposed to maternal chlamydial infection and 40 nonexposed infants was studied after birth for a mean of 3.3 +/- 1.5 and 3 +/- 1.7 mo, respectively. Eighteen (37%) exposed infants had at least one positive culture for Chlamydia trachomatis, whereas C. trachomatis was not isolated from any of the nonexposed infants. Eighteen (37%) exposed infants developed ophthalmia neonatorum (n = 12) or infant conjunctivitis (n = 7), compared with six (15%) of the nonexposed infants (P = .04). Six (12%) exposed infants developed pneumonia, compared with none of the 40 nonexposed infants (P = .05). One infant in the exposed group died during follow-up. These results suggest that appreciable infant morbidity in Kenya may be associated with the high prevalence of maternal chlamydial infection.

Chlamydia Infections↗
PubMed1991

Long-term follow-up of severely injured eyes following globe rupture.

There is little information concerning the outcome of severely traumatized eyes, with little visual potential, which are not removed. We studied 50 eyes, which had suffered severe globe rupture, had visual acuities of no better than hand motion, and were not removed within 2 weeks of injury. Seventeen (34%) of the 50 eyes were later removed. Of the 17, nine had become painful. The other 33 eyes, which were not removed, remained comfortable over a mean follow-up of 66 months (12-161 months). Thirty (70%) of 43 eyes, which had follow-up of at least two months, became phthisical. There were no cases of sympathetic ophthalmia. These results suggest that the majority of severely-injured eyes become phthisical, but do not require removal for pain.

Adolescent↗
PubMed1989

Sympathetic uveitis after giant tear repair.

A 33-year-old Hispanic man developed sympathetic ophthalmia 4.5 months after vitrectomy and repeat scleral buckling for a giant retinal tear in an aphakic previously traumatized eye. The patient had gray-white, subretinal nodules with characteristic changes of sympathetic uveitis detected by fluorescein angiography. The fluorescein angiographic and clinical findings revealed a dramatic response to steroid treatment: visual acuity returned to the previous 20/20 level within 5 weeks of therapy.

Adult↗
PubMed2005

Enucleation versus evisceration.

The choice of enucleation and evisceration for removal of an eye remains controversial in certain circumstances. An international panel was asked to give their surgical management of two clinical cases that require either enucleation or evisceration. Case one follows multiple vitreoretinal procedures, and the risk of sympathetic ophthalmia is considered in the surgical management. Case two has had postoperative endophthalmitis, and the possibility of implant infection following insertion of an orbital implant with evisceration and enucleation is discussed.

Adult↗
PubMedDate not supplied

Three infant care interventions: reconsidering the evidence.

Newborn care in the first 24 hours of life has been based on tradition for many years. Nurses recognize that many practices are not based on good scientific evidence and are not individualized. Instead, all newborns are treated as though they acquire potential pathogens during birth and are oblivious to noxious interventions such as intramuscular injections and heel sticks. In this article, obtaining blood samples from heel sticks and administering vitamin K and prophylaxis for ophthalmia neonatorum are presented as practices that require scrutiny by nurses to promote evidence-based care of newborns in the 1st day of life.

Age Factors↗
PubMed1988

Gonorrhea in the newborn.

Gonorrhea prevalence in pregnant women in the United States is generally low (less than 1%), although the prevalence in certain subsets of the population remains a matter of concern. Rates of 10% have been found in some central city adolescent prenatal clinics. Rates as high as this are quite often found in developing countries. The risks of transmission to the newborn are well studied for ophthalmia neonatorum and are 30%-40%. The risks of disseminated gonococcal infection of the newborn (sepsis or arthritis) are unmeasured, but are clearly rare events. In developing countries, maternal gonorrheal infection has been linked to premature delivery, which had been previously suggested in earlier studies in the United States. There is no evidence that the increasing occurrence of penicillinase-producing Neisseria gonorrheae (PPNG) affects maternal-neonatal transmission other than to require alternative therapy.

Drug Resistance, Microbial↗
PubMed1987

Pregnancy loss, infant death, and suffering: legacy of syphilis and gonorrhoea in Africa.

Africa in the 1980s appears to be facing problems associated with syphilis and gonorrhoea during pregnancy similar in severity and magnitude to those faced by the western world in the early 1900s. From a review of published reports, the prevalence of syphilis seroreactivity in pregnant women in many parts of Africa is at least 10%. Assuming this level of seroreactivity, we estimate that 5% to 8% of all pregnancies surviving past 12 weeks will have an adverse outcome caused by syphilis, such as spontaneous abortion, perinatal or infant death, or a living infant with syphilis. Our findings on gonorrhoea during pregnancy are almost as startling. The prevalence of gonorrhoea in pregnant women in many parts of Africa is at least 10% and it approaches 20% in some areas. The incidence of gonococcal ophthalmia neonatorum in neonates appears to be between 2% and 4%. We recommend commitment of health resources to initiatives to prevent and control sexually transmitted disease in Africa and additional research into the cost effectiveness of different prevention and control approaches.

Abortion, Spontaneous↗
PubMed2002

Ocular applications of povidone-iodine.

Ocular infections can have devastating consequences and may lead to blindness. Povidone-iodine (PVP-I) has many potential advantages over the currently used drugs, including a broader antibacterial spectrum, it turns the surface of the eye brown for a few minutes, bacterial resistance has not been seen and it is cheaper than other agents. PVP-I has made a significant contribution to pre- and postoperative ocular surgical prophylaxis, ophthalmia neonatorum prophylaxis and treatment of bacterial conjunctivitis. Scientific support for these applications includes studies conducted over the past 17 years, which are reviewed.

Adult↗
PubMed1997

Povidone-iodine liposomes--an overview.

In recent years, liposomes have been increasingly explored as novel drug delivery systems, and several liposome-based drug products have been approved in Europe, the USA and Japan. Depending on size, composition and surface characteristics, liposomes interact specifically with biological structures. Liposomal drug products provide a topical activity at the desired locus of action and are deemed more effective and less toxic than conventional drug formulations. The combination of povidone-iodine (PVP-I) and liposomes unites the exceptional microbicidal activity of the antiseptic substance with the excellent tolerability and lack of immunogenicity of liposomes; in addition, liposomes provide a moist molecular film for the wound environment. The multilamellar vesicles act as microreservoirs hence prolonging the release of the active ingredient. Although no commercial product for repeated application on the eye is currently available, PVP-I has been used in ophthalmology not only for pre- and postoperative antisepsis, but also for the treatment of bacterial and viral conjunctivitis and for prophylaxis against ophthalmia neonatorum. For these indications, liposomal formulations with 2.5 and 5.0% PVP-I were developed. These eye drops are isotonic with tear fluid at pH 6. First in vitro tests demonstrated an excellent antimicrobial efficacy, and a placebo-controlled clinical study on volunteers showed a very good local tolerability. A study on rabbits demonstrated positive results of the PVP-I liposome eye drops compared to placebo and the broadspectrum antibiotic Polyspectran in a standardized model of Staphylococcus aureus deep eye infection. The other aim is a well-tolerated liposomal PVP-I hydrogel for improved antiseptic wound treatment with moisturizer. It has been reported that liposomes are enriched at the wound bottom for direct action against infection and support of wound healing. An animal study on the efficacy and tolerability of different formulations of a hydrogel with PVP-I liposomes in deep dermal burn wounds has indicated an outstanding quality of wound healing with smooth granulation tissue, less inflammation, less wound contraction and no hyperkeratotic reactivity, especially with the 3% PVP-I liposome formulation.

Administration, Cutaneous↗
PubMed1982

Prophylaxis of neonatal conjunctivitis. An analytic review.

The recommendation by the Centers for Disease Control (CDC) that erythromycin and tetracycline ointments, as well as silver nitrate solution, are acceptable regimens for prophylaxis of gonococcal ophthalmia neonatorum (GON) has resulted in widespread local review of policies for ocular prophylaxis. The data concerning the efficacy and side effects of these agents are somewhat confusing or nonexistent. We discuss the etiologies of neonatal conjunctivitis and the topical and systemic agents used for prophylaxis of GON. We also review all studies that have compared the efficacy of one prophylactic agent with that of another agent or with no prophylaxis. It is found that all three agents have similar efficacy in preventing GON, although silver nitrate has been used more extensively in populations at high risk for GON. However, since Chlamydia trachomatis is the most common infectious cause of neonatal conjunctivitis in the United States at this time, and erythromycin appears to be very effective in prevention of neonatal conjunctivitis due to C. trachomatis, it may have an advantage over the other two agents. In addition, erythromycin use is associated with fewer ocular reactions than is silver nitrate.

Administration, Topical↗